Abstract

We present a case of a healthy, full-term female who at birth had a 3-mm soft, skin-colored pedunculated papule on the left nasal dorsum, which was biopsied at two weeks postpartum. Histologic examination revealed aggregates of variably-shaped vacuolated cells set within a fibrillary stroma, which were reactive for glial fibrillary acidic protein (GFAP) and S100, supporting their glial origin. The diagnosis of nasal glial choristoma was rendered, and imaging was recommended to exclude intracranial communication. Glial choristoma is a rare developmental malformation consisting of ectopic central nervous system tissue that presents as a papule, pedunculated lesion or subcutaneous nodule on midline structures of the head and neck. It most commonly occurs at birth or within the first two years of life. Histologic findings include non-encapsulated aggregates of mature glial cells within an eosinophilic neurofibrillary stroma. Multinucleated giant cells and stromal fibrosis are variably seen. Malignant transformation has not been reported, but distortion of underlying structures or infection can occur, and conservative excision is recommended. Although glial choristomas are not associated with intracranial extension, MRI should be performed prior to biopsy or excision of midline lesions to evaluate for intracranial communication.

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